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Author
Topic: the price of life (Read 8590 times)

Another thread says ADAP waiting lists are growing in the USA.I was reading my Sunday Times and came across this article:

http://www.nytimes.com/2009/10/11/health/11fertility.html?_r=1&hp21st Century BabiesThe Gift of Life, and Its Price In one year, the Masteras spent 23 percent of their income on fertility treatments.The couple had nearly given up, but last year they decided to try once more, this time through in-vitro fertilization. Pregnancy quickly followed, as did the Mastera boys, who arrived at the Swedish Medical Center in Denver on Feb. 16 at 3 pounds, 1 ounce apiece. Kept alive in a neonatal intensive care unit, Max remained in the hospital 43 days; Wes came home in 51.By the time it was over, medical bills for the boys exceeded $1.2 million.

As the article continues, one quickly realises the "price" is in health risk to the babies. Then there is discussion of the business of fertility treatments. And the out of pocket costs to the couple.

No discussion of who pays that 1.2 million because obviously its spread around either by the hospital forgiving it, finally, or the insurance company spreading it to all customers.

There is no way my HAART is ever gonna cost this much in a lifetime.

Just got me thinking.

Logged

“From each, according to his ability; to each, according to his need” 1875 K Marx

No discussion of who pays that 1.2 million because obviously its spread around either by the hospital forgiving it, finally, or the insurance company spreading it to all customers.

Read a little more comprehensively my friend :

"The government estimates that caring for premature infants costs $26 billion a year, including $1 billion for IVF babies, expenses that eventually get passed through the system and on to businesses and consumers."

I would tell you which paragraph that is but I am too damn lazy to count right now. I know one thing the article doesn't mention though, how many of the wanna-be mass baby producers are on waiting lists. Hmmm, my guess not as many as those who are on ADAP waiting lists.

Ah, cool thanks! My morning coffee hadn't kicked in I guess.When I see the 1 billion for IVF babies it's abstract. When I see 1.2 million for this couple's adorable tots, it's concrete - at the level of the individual.I posted it to activism cause I think "price point" is part of the politics of AIDS.Surely in the USA.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

Ya know what's really cool is how they are also taxed less... they also get something cool called earned income credit. However, I believe it cuts off at child #4. This is where real parenting skills come to play, when they space the little puppies out so when one set turns 18 you still have a set of quint 8 year olds to take their place.

Another thread says ADAP waiting lists are growing in the USA.I was reading my Sunday Times and came across this article:

http://www.nytimes.com/2009/10/11/health/11fertility.html?_r=1&hp21st Century BabiesThe Gift of Life, and Its Price In one year, the Masteras spent 23 percent of their income on fertility treatments.The couple had nearly given up, but last year they decided to try once more, this time through in-vitro fertilization. Pregnancy quickly followed, as did the Mastera boys, who arrived at the Swedish Medical Center in Denver on Feb. 16 at 3 pounds, 1 ounce apiece. Kept alive in a neonatal intensive care unit, Max remained in the hospital 43 days; Wes came home in 51.By the time it was over, medical bills for the boys exceeded $1.2 million.

As the article continues, one quickly realises the "price" is in health risk to the babies. Then there is discussion of the business of fertility treatments. And the out of pocket costs to the couple.

No discussion of who pays that 1.2 million because obviously its spread around either by the hospital forgiving it, finally, or the insurance company spreading it to all customers.

There is no way my HAART is ever gonna cost this much in a lifetime.

Just got me thinking.

Had the same reaction to that articile

Studies of the average cost for lifetime HIV treatment are about $600 K. (A writeup here of a study http://www.aidsmeds.com/news/am20061103.html Similar results in a 2009 study )Of course those HIV studies appear to assume that patients will stay on patented drugs for lifetime (no large savings as drugs go generic)

But the politics of directly pitting helping infertile couples have children against helping people with HIV would likely be really poisonous. And it is not at all clear that people with HIV would come out better off at the end of the day.

Couldn't a few more people just adopt and save themselves and everyone else a lot of pain risk and expense? And help out some being already in this world?

I wonder if clients going to fertility clinics are told about the potential risks and expenses.

I would never advocate a specific priority of this medical challenge versus that one, versus another.

I'm more interested in the general topic of the price of life. Very au courant in the health care debate.

And then how it is that something so easy and available as HAART, yet expensive, can be withheld in a rich country, which can afford 1.2 million dollar twins. Or maybe it can't afford the latter, either.

Logged

“From each, according to his ability; to each, according to his need” 1875 K Marx

Agreed. I can't help feeling that the parents who will move heaven and earth to have a biological child rather than adopting are having children for narcissistic reasons -- it has to be a piece of them, or they don't want it.

But of course no child, biological or not, is really yours or part of you, and parenting that tries to treat them as such can be terribly harmful.

I have to agree. I understand the desire to have kids but, damn, why not adopt? I know a single (heterosexual) woman who is going to a fertility clinic - it is all being paid for by insurance - but probably could easily have just been impregnated the traditional way (sex). She chose the fertility clinic because she can better screen the sperm donor + knows the man will sign away his parental rights. On the flip side, I'm sure she's not thrilled she's (theoretically) subsidizing my HIV drugs.

I think someone has lost what the jist of this thread is about. It's not about having one kid and the cost incured from doing so. No, it's about people who go on fertility treatments, have 5+ kids which are all in need of extensive medical care in the beginning of their life. It's a much smaller group than those lving with HIV/AIDS, but it probably cost as much if not more on our healthcare system.... and the article clearly states that this cost is passed on to us, not the parents.

All three of my children and the cost associated with having them were footed by their parents. Kate +8 comes to mind here... wonder what would be if TLC would not have stepped in?

Yes let me push the analogy and comparison further. I read about the Arkansas people getting dumped off ADAP and the coming crunch for ADAP dependent people everywhere. Then I read about these 1.2 million dollar twins.

I am curious about the mechanics of the cost.

So, the middle class couple wants children, is having problems and goes for fertility treatment. Maybe their insurance pays, maybe it doesn't. They scrap together the money. The fertility clinic does its job.

The happy couple go to the hospital and out pop the babies and they need a mil or two of health care. The couple can't pay. Their insurance won't pay? Doesn't have to pay. Or maybe they didn't have insurance? And so the cost gets spread around to everyone.

Maybe that cost should go back unto the fertility clinique? I dont think its possible to say only couples with medical coverage for the whole process can use clinics....

Now the HIV+ on HAART. The time for HAART comes up and he has no insurance and no personal funds so he gets government money to pay for the HAART. The cost is shared around. But wait, no, not everyone can have the HAART. Not enough money.

It doesn't have to e HIV, as I said, it could be any group of poor people with an expensive to treat disease.

So we need a bigger survey.... We need one of those charts that compare the costs of treating all sorts of medical challenges and diseases. And then some kind of ratio - cost and percentage of cost paid for by public, rather than patient.

But back to the important matter. If I understand, under the Bush years, there was a long stretch where any American needing HAART got it, regardless of ability to pay. Is this true? And now universal treatment is vanishing again?

Is it possible the HIV+ person runs out of HAART, can't pay, goes to the hospital, and is told, yep, maybe you can get it eventually, here is the waiting list, good luck?

SO then we get to questions at the heart of the health care debate. Where to allocate limited public monies. But who decides to send the HIV+ home to suffer and die, yet birth the wonder fertility babies? The hospital?? The state, somehow?

This is getting into death panel territory however, if we say someone has to make decisions. Someone says, yes, lets treat 10,000 people with HAART at 20,000 bucks each a year, but for life. Or lets birth the babies and help them survive.

In Switzerland, as in many countries, it goes more smoothly. The government's health panel makes decisions on the minimum health service and minimum treatment due to each health challenge. The private insurance companies have to accept anyone into a basic plan that will cover all the minimums. HAART, obviously, is a minimum. As is 2-4 x a year specialist visit, and any lab work he/she requests. And so on.

If a person is poor and can't pay the MANDATORY minimum health policy, the government must subsidize the policy.

The drug companies are private. The insurance is private. The hospitals are private and public. Etc etc.

Its really not that terribly difficult for a rich country to do the minimum humane medical care for all its citizens.

When I seroconverted, I told my Swiss friends how scared I was about being guaranteed treatment for the duration. They really couldn't understand. Its so alien to so many Europeans, this gripping fear that is the birthright of Americans. "I'm OK, but I'm one layoff away from total ruin, homelessness. One disease away from sickness and death."

Incredulous stares. "That will never happen here" they say. Hope they right.....

« Last Edit: October 12, 2009, 02:23:13 PM by mecch »

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“From each, according to his ability; to each, according to his need” 1875 K Marx

But back to the important matter. If I understand, under the Bush years, there was a long stretch where any American needing HAART got it, regardless of ability to pay. Is this true? And now universal treatment is vanishing again?

Is it possible the HIV+ person runs out of HAART, can't pay, goes to the hospital, and is told, yep, maybe you can get it eventually, here is the waiting list, good luck?

If I understand, under the Bush years, there was a long stretch where any American needing HAART got it, regardless of ability to pay. Is this true? Not really. It's more accurate to state that during the Bush / Republican Congress years the ADAP lists got so long that eventually they came up with extra emergency monies to get the lists back under control in 2004. But even with the new money lists remained until the new Medicare Prescription Drug plan kicked in additional funds during 2007.

"Since 2002, a total of 20 different ADAPs have instituted a waiting list at some point, and in May 2004, waitinglists reached a peak of 1,629 people, resulting in onetime additional funding from the federal government. Thisadditional funding, Medicare Part D, and improved state fiscal conditions led to the elimination of waiting lists inSeptember 2007, for the first time. However, waiting lists have once again emerged." http://www.kff.org/hivaids/upload/7861.pdf p. 16

See also association of state ADAP directors issue brief on managing ADAP waiting lists from 2007 -- it has a brief history. http://www.nastad.org/Docs/Public/Publication/200819_17823%20Brief%204%20-%20Waiting%20List.pdf

Thanks for the document. I read it. It made me anxious. I took a calmant...

I see that ADAP and federal funding is a necessary and good thing - it was better than nothing, before. But i see in that document, that there is a lot about how to manage a wait list.

It is therefore a layer of management that does a double action - on the one hand, it gets money from the government to deserving patients. On the other hand, it does the work of keeping people from money, when there isn't enough money.

What is the price of life......

Is it a crime for a state or a nation to withhold medically effective and cost efficient treatment for an otherwise costly and deadly disease?

Do treated people cost less in their lifetimes than people who get sick and die without treatment, or do they cost more?

1.2 million for 2 twins. Thats 600,000 in one year for one life. We assume the costs go way down as the twins grow into healthy independent children.

This study looked at the question in Ethiopia: To estimate the average per person year (PPY) cost of care for HIV patients with and without anti-retroviral therapy (ART) in a district hospital. http://www.resource-allocation.com/content/7/1/6Findings

PPY average (95% CI) costs under ART were US$235.44 (US$218.11–252.78) and US$29.44 (US$24.30–34.58) for outpatient and inpatient care, respectively. Estimates for the non-ART condition were US$38.12 (US$34.36–41.88) and US$80.88 (US$63.66–98.11) for outpatient and inpatient care, respectively. The major cost driver under the ART scheme was cost of ART drugs, whereas it was inpatient care and treatment in the non-ART scheme.

So in Ethiopia, it costs a lot more for a treated patient.

I looked for annual average cost for the moyenne of HIV/AIDS and couldnt find a recent figure. 2008 would be nice!

In 2006, it was 600,000 USD for a lifetime for a person who had HIV. Lifespan was then estimated at 24 years.

I wonder if lifetime cost goes up, or down, with really effective HAART, and earlier treatment? Live longer, but longer on expensive medicine, longer under close supervision.

Isn't that IRONIC however. The miracle twin baby costs the same (in one year) as the lifespan of an HIV testing positive today....

And both costs are ASTRONOMICALLY higher than the costs in Ethiopia.. of course...

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“From each, according to his ability; to each, according to his need” 1875 K Marx

Let's say my cost from serocoverting last year is more or less 600,000 until I die. Just a rough estimate. If I make 100,000 a year for 20 of the next years, society has decided that I've contributed 2,000,000 of value to society, but I also have to received 600,000 collectively from insurance payers or government.

We can see how capitalists could be afraid of death panels. They'd make so much sense in capitalism.

Logged

“From each, according to his ability; to each, according to his need” 1875 K Marx

I was shocked when I came across this thread. We have major health care issues here in the US, but you just can not compare the two issues. All life is precious.

mecch "Couldn't a few more people just adopt and save themselves and everyone else a lot of pain risk and expense? And help out some being already in this world?"

daysleeper "Agreed. I can't help feeling that the parents who will move heaven and earth to have a biological child rather than adopting are having children for narcissistic reasons -- it has to be a piece of them, or they don't want it."

I have to say I find both of these comments way off. I under went 3 unsuccessful IVF treatments before adopting my son. I wasn't being narcissistic when I chose to try IVF. Adoption involves a lot of risk and expense unless you choose to adopt older children instead of an infant. It also involves exposing your life for others to examine to decide if you can adopt. My husband and I had to have home inspections, background checks and interviews to make sure we would be fit parents. We also had to attend classes on adoption. Then we waited for an infant to be available. Once we met our son in the NICU the personal invasion was not done. We had to have him in the home for 6 months before the adoption could be finalized. During that time we had to have home visits to be sure that we were doing a good job. There is also the risk that the biological parents could change their mind and take the baby back. My friend also was unable to conceive. She choose adoption. She paid a huge amount of money for medical and living expenses to a biological mother who was giving her child up for adoption. Well the woman changed her mind and my friend was left out of all that money and still childless. Unfortunately she never will have a child, she can't afford to try again and is just too afraid to try even if she could. For myself, I'm now the proud momma of Lucas who is a beautiful 3 year old and HIV+ as well as having mild CP. I wouldn't give him up for anything . Due to the cost and personal invasion I probably will not be adopting again.

A lot of people seem to think adopting a baby is easy. Unfortunately a lot of babies who should be put up for adoption are not. The biological parents mess with the child's life because they feel he/she is theirs. They either continue to do that indefinitely or the child is taken away, but not until after suffering mental and/or physical abuse . Maybe if more biological parents made the loving dicesion to place their child up for adoption and the adoption process was easier more people would opt for adoption over IVF.

This was really disturbing to read this thread because this goes back to the thinking that adoption is free and painless. I know one couple who spent, at minimum, 40 grand to adopt and the red tape was overwhelming. Years and years of waiting and hoping after feeling rejection from their own bodies.

You know, unless you've been in the situation and lived it, it's unfair to read one article from the NY times and create this blanket opinion.

On another note, I used to live on a street where they had a fantastic Aids facility for housing etc. My ex mother -in law and others in town would make horrible comments about how people with Aids are chewing up our health care and should have thought twice before sticking the needle in their arm or bending over. Obviously she didn't know that her ignorance was greater than she would ever know. Her comment was not just terribly hurtful and narrow minded, but it did nothing to help the cause of our health care nightmare.

Ladies, thanks for chiming in on the discussion. Being a parent myself, who was once married to a woman who took fertility medicine in attempts to get pregnant, I understand why this method is necessary. However, I think you missed the point at the very top of mecch's initial post in this thread:

These lists include men, women, and children. No one in this thread is denying that women should not have it in their right to choose any means possible to become a mother. Whether that means is: as easy as natural conception, fertility drugs, or adoption, I support it and I don't necessarily see anyone else saying otherwise in this thread.

This was really disturbing to read this thread because this goes back to the thinking that adoption is free and painless. I know one couple who spent, at minimum, 40 grand to adopt and the red tape was overwhelming. Years and years of waiting and hoping after feeling rejection from their own bodies.

I think the ones feeling the most pain are the children waiting to be adopted.

You know, unless you've been in the situation and lived it, it's unfair to read one article from the NY times and create this blanket opinion.

If read carefully one can see where mecchs first line at the top of the thread is coming from. These 5 children alone are taxing the healthcare system $1.2 million projected. It also states that this is the norm for all couples having quadruplets and quintuplets.

Now which ever way you wanna look at it, how do you prioritize the need for someone to be a parent and the need for someone to receive medicine to stay alive?

On another note, I used to live on a street where they had a fantastic Aids facility for housing etc. My ex mother -in law and others in town would make horrible comments about how people with Aids are chewing up our health care and should have thought twice before sticking the needle in their arm or bending over. Obviously she didn't know that her ignorance was greater than she would ever know. Her comment was not just terribly hurtful and narrow minded, but it did nothing to help the cause of our health care nightmare.

And what your lovely ex mother-in law failed to realize is that just about everyone here got this "Aids" by doing something everyone at one time has done, unprotected sex. Whether it was the first time, man to man, woman to man, 1000th time, it all had to do with unprotected sex. Now you ask ex whatherface if she's always used protection..... especially while attending Woodstock.

If the healthcare system wants to see a nightmare wait til those not receiving medicine start having to stay at the General Hilton Medical facility overnight with all the trimmings....

Putting a price on ANY life is absurd. What is your life worth? ARe you somehow more worthy than a child? Are your choices, and their consequences, in life more worthy of support than someone else's? Mim's HIV treatment topped $1mill by the time she was 18mths old. She's now 9 - you do the math. Is the expense of her healthcare now putting her under the category of "unworthy" because she falls under someone's twisted idea of expensive?

Putting a price on ANY life is absurd. What is your life worth? ARe you somehow more worthy than a child? Are your choices, and their consequences, in life more worthy of support than someone else's? Mim's HIV treatment topped $1mill by the time she was 18mths old. She's now 9 - you do the math. Is the expense of her healthcare now putting her under the category of "unworthy" because she falls under someone's twisted idea of expensive?

The price of life? Priceless.

Deep breaths... re-read the article and then you might see the points giving here have absolutely no bearing on the direction your taking the thread. Hell take all of the people off ADAP and let mommies all over the world have 5+ childdren at one time. Is that what you would like? I think if some people could take the time to read the article they would find the arguement they are creating within themselves in senseless and not what this thread is about.

Somehow.... someway you have construed this to be an attack on children.. Read the article before you read the thread... it might just come all together for you.

I did read the article before posting. The article was about the high cost for care for some babies from IVF. Your argument seems to be that infertile couples should adopt, there by increasing the amount of money for ADAP. I have 2 points to make:

1 Not all babies from IVF result in those high health care costs.

2 Because you already require expensive medical treatment, you want to stop others from having a choice because it might result in a baby who requires expensive medical care.

I don't think that's fair. All life is valuable, and I don't feel that it is your right to say that your needs are more important than someone else's. If we followed your logic then you might as well say that no one who is HIV+ should ever be allowed to have sex with someone negative because it might result in someone else requiring expensive health care. Before anyone gets mad I'm not suggesting that +/- couples should be banned. I'm just saying that it makes as much sense as stopping couples from using IVF.

I did read the article before posting. The article was about the high cost for care for some babies from IVF. Your argument seems to be that infertile couples should adopt, there by increasing the amount of money for ADAP. I have 2 points to make:

1 Not all babies from IVF result in those high health care costs.

2 Because you already require expensive medical treatment, you want to stop others from having a choice because it might result in a baby who requires expensive medical care.

I don't think that's fair. All life is valuable, and I don't feel that it is your right to say that your needs are more important than someone else's. If we followed your logic then you might as well say that no one who is HIV+ should ever be allowed to have sex with someone negative because it might result in someone else requiring expensive health care. Before anyone gets mad I'm not suggesting that +/- couples should be banned. I'm just saying that it makes as much sense as stopping couples from using IVF.

LOL.... So you think cats should all be put to sleep?

And I would like to take the time to say your thoughts that I think "infertile couples should adopt" are wrong. Here is the argument that I am making:

How does the healthcare system justify backing up a perceived want for something that is already here?

Example:

1. I want 5 little Johnny's so I can start up my own basketball team-- Perceived Want. 2. Little Johnny can't get his Atripla this month because ADAP is cutting back-- Something that is already here.

Just seems a little backwards to me. Sorry you ladies feel differently...

The couple who needs IVF, may be a lesbian couple who lives in Florida, who are barred from adopting children, simply because they are gay. So what option do they have to start a family? They can't adopt, but if they conceive, then great. I also disagree with any comparison about a newborn needing extensive critical care, vs. ADAP funding. In the case of ADAP, we have an idea of how many are infected and what there meds will cost, so underfunding ADAP is a moral failure on the part of our government, plain and simple. The newborn however, comes with no such estimate of how much care they may require. If you are suggesting that a cost/ratio should be determined, upon their birth, then now you are talking death panels.

Further, if our health care system functioned reasonably well, that $1.2 million would be more like $800K and a months worth of HIV meds would cost about $300. Until we are able to conceive of a system that is equitable, yet humane, in treating our sick, we will always be pitting ourselves, between what we know is right and what we can afford.

Skeebo 1969 - Second verse same as the first. You already have a need because of choices you made (something already here). People want to have children (perceived want). Healthcare funds should go to you, because your actual needs came first and if that means limiting others right to choose oh well . Yeah, that's fair.

Most people undergoing IVF are not looking to have a basketball team. They just want to have a child. The IVF industry has guidelines to help prevent such multiple births. Unfortunately they are largely ignored. The industry is looking for ways to make changes so that the number of multiples from IVF drops.

The entire heathcare system needs reformed. For example, I have a friend who works at a lab that makes dentures. She said that on average the lab gets paid $125 for a full set. In turn the Dentists sell them for $800+. That's crazy. We need to have major changes in the healthcare system. Trying to argue my need is more important than yours is a waste of time.

Skeebo 1969 - Second verse same as the first. You already have a need because of choices you made (something already here). People want to have children (perceived want). Healthcare funds should go to you, because your actual needs came first and if that means limiting others right to choose oh well . Yeah, that's fair.

Yep they should go to me. I pay for my crap... If I pay the premiums and my wife and I struggle through medical bills then hell ya... I better be paying for my services and not someone else's. Oh but wait, that's not what you are referring to now is it? No you are talking about the person who is in need of these programs to stay alive huh? Yeah, that woman, guy, or child is who you are referring to right? They made the choices to have to need this assistance so in other words to hell with em? Big deal kick em off ADAP in other words? Yet, hey let's support something that equally puts a burden on the healthcare system.... well because they didn't do nothing to deserve this?

"Yeah, that's fair"

Sounds good to me...

"Most people undergoing IVF are not looking to have a basketball team", LOL true.... but trying to get the upper hand on Jon and Kate plus 8 perhaps? Just joking..... sheeez I can already read the replies..

Anyhow... all I am saying is I find it rather ironic is all. Actually very ironic and sad, but hey that's just me....

Wouldn't mind a son myself.. that way I could put down all these Barbie dolls my daughter's make me play with and get outside and throw some football.... hell wouldn't even mind having enough sons to start a 52 man roster football team...

Well, you can't start talking about taking away people's choices, no matter what they are.....engaging in risky behavior that may result in something, or someone's want of a baby. To start limiting what people can do is getting into dangerous and questionable territory.

Amy's (#1 mom) right about the healthcare system. And of course we already know this. I hope the IVF industry gets their mishaps under control, so people won't have all these multiple baby incidents.

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I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

They made the choices to have to need this assistance so in other words to hell with em? Big deal kick em off ADAP in other words?

Of course I don't want to see people kicked off ADAP. And I also did not mean to imply that everyone on ADAP deserved what they got because of choices they made. I just think that trying to argue IVF verses ADAP is sensless. The whole system needs to change. Any argument that suggests limiting choices for one group in hopes of having more funds for another group is dangerous. Once that happens, who is to say where it will end .

Under capitalist, socialist, communist, or whatever system. Today 2009, 1989, or 1789. There is always going to be a price on life. Ideally, life is priceless. My post was about the messy reality.

To reduce the post to IVF versus HIV is to miss my rumination - generally, what is the price of a life. HIV and IVF serve as data for a general discussion. Ironic choices considering the shared 600K figure.

Its been a good discussion at least, hasn't it?

Any system is going to make decisions about who gets limited resources. These decisions may or may not be deliberate. May or may not be related to market forces. Or legislation. Or judeo christian morality. Whatever. Countries with universal care make these decisions - cause not every citizen can get the most most most "cutting edge" care if its astronomically expensive. 2 million for 6 months additional life span. Sorry, it's gonna get denied. Etc.

It's interesting all the shoulds - yes, HAART should cost less. Yes, couples hoping for a baby shouldn't get 6 due to sloppy science or poor practice.

At the end of the day, if something so G D simple and effective as putting a HIV positive person on HAART to prevent sickness, cant be done because HAART can't be paid for, in a rich country, then available public monies have been spent foolishly, somewhere. Maybe it was those G D wars and wall street bailouts, then.

« Last Edit: October 16, 2009, 11:19:06 AM by mecch »

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“From each, according to his ability; to each, according to his need” 1875 K Marx

though I really don't want to get all embroiled in an argument here, I have been surprised to see that some simple facts are simply ignored. So I'll probably step into a pile of poo anyway with my comments LOL

The undeniable fact is that the world and it's people have only limited resources. (well, until space travel can get us to other worlds to retrieve more natural resources) I believe that those resources are better spent on the health and well-being of people who are already alive (regardless of age, gender, race, etc) than spending money to help create more people.

Quite simply and quite frankly, there will be plenty of people born by natural methods to keep the world populated without spending valuable limited resources to potentially create more lives. Many areas of the planet are already having issues with too many people being created and not enough resources to care for them. And that's what we are probably discussing here. Price (the amount of the limited resources) does have to be taken into account. If we do not have the resources to care for the people already created and living here (ie ADAP funding cuts), then we obviously do not have the resources, or the moral high ground (ie just "wanting" a baby), to create more people (IVF procedures) by using those already scarce resources.

Having a child is not a right. Many people are unable to biologically or through their own choice. However, I as an American do believe that individuals DO have a right to life - and that may rquire using the planets limited resources for health care to maintain that life. Our lives do have a price/cost attached to them because that's how we understand and use a system to allocate the resources on the planet. (a very vulgar example is: it would be nice if everyone could eat steak but we can only afford hotdogs because there isn't enough beef to go around, plus beef costs more) I don't value any one's life any less than mine for any reason (age, gender, race, etc); but I do value the lives and rights of people (here, now, alive, and breathing) over the rights of the "possibility of a person" (a non-entity, the yet to be created unborn).

ADAP and other such programs should be fully funded first and then IF there is money left over, then we could spend the surplus on non-essentials - like steaks for everyone or procedures to create children, especially when the good old fashioned way (sex) is free and still doing the world just fine.

My wife told me I can't have 52 sons so I could start my own NFL franchise... I'm willing to put in the work why ain't she? We could have done it in roughly 6 1/2 pregnancies the way I figured it.... man I'm really bumming right now. I think with my temper and her genes we could have made one hell of a middle linebacker....

Whelp back to the Barbie dolls.... I just hate when my daughter gets mad at me for Karate fighting with the two Kens from different culture backgrounds, but who have the same exact facial features and physique....betcha the lil shits were conceived through IVF.

If everyone agrees that having HIV infection (a medical condition) deserves treatment, how do we really argue that infertility (a medical condition, also) is less deserving of treatment?

Do we rank order all the possible medical conditions and go down to some "line" where the money runs out and say, "OK, all conditions below this line are less deserving, so there is no money and you don't get your treatment."

It really is pointless to try and say condition A is more deserving than condition B. Especially when you have condition A (and probably don't have conditon B). At the end of the day, the most "deserving" condition is likely to be yours.

If everyone agrees that having HIV infection (a medical condition) deserves treatment, how do we really argue that infertility (a medical condition, also) is less deserving of treatment?

Do we rank order all the possible medical conditions and go down to some "line" where the money runs out and say, "OK, all conditions below this line are less deserving, so there is no money and you don't get your treatment."

It really is pointless to try and say condition A is more deserving than condition B. Especially when you have condition A (and probably don't have conditon B). At the end of the day, the most "deserving" condition is likely to be yours.

Mike

Hey that's a great point you're making there, but one of those outta A & B conditions will die and the other will not. Once again I think it is their right to do what they want.... the desire to have children can be a strong one, and I totally understand why couples would seek any means necessary.

It's a screwed up system. This whole IVF and HIV cost comparison could have been replaced with any number of ill advised spendings this country's government is guilty of doing. I still want one of those $300 hammers the government buys for the military or one of those fancy $29 nut and bolt we use to put our military craft together. Or the $35 tylenol tablet from the local hospital... I think it has gold inside.

Instead I have to settle for the regular $7 hammer from the local Home Depot....

If everyone agrees that having HIV infection (a medical condition) deserves treatment, how do we really argue that infertility (a medical condition, also) is less deserving of treatment?

i think that analogy is more like apples vs oranges as "medical conditions" come in all flavors.

hiv is a terminal life-ending disease for those who are already born, breathing and alive; while infertility is not a life threatening condition at all. no one dies from not having a baby, as evidenced by the millions who do not procreate.

I still want one of those $300 hammers the government buys for the military

however those hammers do not actually cost $300. That is actually one of the way a gov't hides spending, that has to be shown on the books, for clandestine operations. the hammer still only costs $7 but $293 is going to build a satellite that will observe Al quida or China, or pay for a blackwater operation to rescue a spy, etc. Those sort of govt actions must be paid for; but if actually listed on an accounting spreadsheet would cause serious security issues.

i still think that in the big picture the earth's limited resources really need to be spent on actual living humans than on beings who are no more than mere desires and ideas. It's hard enough now to get aide to real people much less trying to pay for someone's dreams. This isn't about choosing one medical condition over another really; but choosing to spend on real people here and now, or on imaginary wished-for people that someone "wants" and doesn't necessarily "need".

I believe that those resources are better spent on the health and well-being of people who are already alive (regardless of age, gender, race, etc) than spending money to help create more people.

Well the cost that are being discussed (1.2 mil for the twins) was not to have the IVF procedure. (The procedure expense was much less and not paid for from public money.) That was the cost to help keep the twins who are already alive living.

Well, you may say they wouldn't have needed such care if not for starting from IVF. That may be true, but you could say that for many things.

No cigarettes = less lung cancer and heart diseaseNo high fat foods = less obesity and heart diseaseNo sex for people with HIV = lower transmission rates and less people needing ADAP

Ideally, life is priceless. At the end of the day, if something so G D simple and effective as putting a HIV positive person on HAART to prevent sickness, cant be done because HAART can't be paid for, in a rich country, then available public monies have been spent foolishly, somewhere. Maybe it was those G D wars and wall street bailouts, then.

i think that analogy is more like apples vs oranges as "medical conditions" come in all flavors.

hiv is a terminal life-ending disease for those who are already born, breathing and alive; while infertility is not a life threatening condition at all. no one dies from not having a baby, as evidenced by the millions who do not procreate.

You're stuck on the specifics and missing the larger point here. Pitting one condition against another for "worthiness of treatment" is dangerous. Here is another scenario -- my father has macular degeneration -- it isn't going to kill him, but it has made him blind. He had treatment that left his eyesight for a bit longer -- is that "less deserving" of treatment? He's here, living, breathing -- but he "wants" his eyesight -- he doesn't "need" it to live, so in your logic, it is less deserving. Or..... maybe you were simply speaking about procreation and just feel that that is less deserving. Regardless -- a dangerous postion to take, because someone, somewhere is going to see that HIV is "less deserving" than something else.

Pitting one condition against another for "worthiness of treatment" is dangerous.

HIV/AIDS is not a "condition" at all , rather it is a life threatening disease that kills. (I have two long term partners whom are dead to prove that) Infertility is not a disease, nor is it even a terminal condition. As a male who is unable to birth a child, I think of infertility as perhaps an inconvenient condition. No one "needs" to birth a child to stay alive, nor to live a happy, healthy, productive life either. People only desire/want to have children as a biological drive. It is not a biological imperative to living such as breathing or eating.

my father has macular degeneration -- it isn't going to kill him, but it has made him blind. He had treatment that left his eyesight for a bit longer -- is that "less deserving" of treatment? He's here, living, breathing -- but he "wants" his eyesight -- he doesn't "need" it to live, so in your logic, it is less deserving

no. quite the opposite; you missed my point. I was arguing that your father actually does deserve some of the limited resources for medical treatment right now because he IS an actual living breathing human; rather than those same limited resources going to produce a potential human. (until a child is conceived and/or birthed there is no other human involved, just the idea or a desire for a human) Do you think your father should have to go blind in exchange for someone else getting the potential to create another human? I don't. I think he deserves medical treatment before someone (maybe like the Suleman woman that had 8 children) is given that kind of chance for an elective procedure that could result in using up that many resources.

That was the cost to help keep the twins who are already alive living.

I do concede that you are correct #1 mom. the parents in this situation incurred that cost themselves. However I wasn't arguing that we deny these living children care, I was trying to point out that we acknowledge that producing a child COULD incur extra health care costs on top on the costs of actually going to such extreme methods to even create that child in the first place. One never knows. That's a lot of money we're talking about in a situation like that, and there are very few people on the planet that can take the fiscal responsibility for such a situation. If that cost is going to be spread around, then we need to consider how that cost will effect those already living.

Unfortunately, everything, be it air, water or dollars are limited resources on our planet. (well everything except LOVE ) Someone has to either make and/or pay for all these services, procedures, medications, etc. There is no endless supply (though granted in this day and age, we should have enough) to fill every demand. As time goes by this situation will only worsen. Don't blame me, blame entropy.

No cigarettes = less lung cancer and heart diseaseNo high fat foods = less obesity and heart diseaseNo sex for people with HIV = lower transmission rates and less people needing ADAP

Now we're kinda going into an off-topic area, None of those items is actually needed for anyone to stay alive, and all of those can be consciously chosen, so honestly, I could proably go along with most of those items in your list being regulated to prevent further problems.

I quit smoking 260+ days ago (woohoo! ) to prevent any future heart/lung issues (as I don't already have those problems). Having grown up in the tobacco state of NC, I can assure you that currently America has been regulating cigarettes more and more as the years go by, exactly because of the adverse affect, so we are already "going down that path" so to speak. (I actually quit smoking because I couldn't afford cigs anymore due to the increased taxes, so their evil plan to regulate my actions is working)

Since I still weigh what I did when I graduated from high school 30 yrs ago (actually since moving back home from Oh to SC to live with my mom, I'm a little heavy so I'm at my after-christmas-I-ate-too-many-cookies weight), bike regularly and eat in moderation, I probably shouldn't speak about that "obesity" issue since eating high fat foods doesn't adversely affect me the way it does a majority of people. People who do have an issue with it and do eat it (and in America many have chosen to OVEReat and to eat unhealthy) are actively choosing to ruin their own health and there are already calls to regulate or tax people for those items in an attempt to defray the medical costs those "bad habits" create. Since I am not burdening the state with health costs incurred this way, those calls for taxes on junk food do bother me, but I guess I'll have to lose a little of my perceived "right" to eat what I want so all those fatties get the message and quit clogging up their arteries and dying. (please note that I am being derogatory about overeaters, unhealthy eaters and lazy people being "fatties" not people with medical conditions )

Finally, I have already chosen to have safe sex or have no sex at all in order to lower transmission rates. We're on very shaky grounds here discussing doing something legally about regulating sex (riskier than discussing regulating IVF procedures LOL), but many HIV+ people are already fearful of and cognizant of spreading the disease and their "self-regulation" (of using condoms or not having sex) is already creating a positive effect, I would argue.

Regardless -- a dangerous postion to take, because someone, somewhere is going to see that HIV is "less deserving" than something else.

Thank you ALL for the lively discussion. As #1mom told me and I agreed, I believe we'll have to agree to disagree on this topic. I just believe that real living, breathing people are more deserving of care than unreal, unconceived, unborn people. After they're born though, then I would agree, and demand , that no one is "less deserving" than another to receive medical treatment. However I also think that giving birth to a child is a not a right because many people (men and infertile women) are simply incapable. In a world of limited resources that someone must pay for, I just think it's more appropriate to fund ADAP and pay for our parent's health problems than it is to fund people's desire to create a new life when that act can and is accomplished by so many people daily at no cost.

I was trying to point out that we acknowledge that producing a child COULD incur extra health care costs

And I just wanted to point out that we should acknowledge most any behavior COULD incur extra health care costs and that it is a slippery slope. Believe me I don't support Suleiman and I feel sorry for her children.

Rather than argue about fertility treatments, I think we would be further ahead talking about other drains on the public money pie. I'm a nurse and for the first 10 years I worked in the ER. You really see some of the best and worst of humanity working there. I have no problem with people getting assistance who need it, but the system is often abused which leaves less for those who are truly in need. Here are just a few of the things I've observed over the years that really are a drain on the system:

Patient comes in to the ER because they've had the sniffles for a few days. They have a type of MA that requires you to call your primary doctor first. When I asked if they spoke with their doctor I was told they where offered an appointment. yesterday, but that wasn't convenient so he didn't go. Today when they called they were offered an appointment but it was 2 hours from now and that was too long to wait. When I mentioned that an office visit would be a lot cheaper, they responded "oh well it's not like I'm going to pay the bill anyway" .

Mother on assistance brings her child into the ER for an ear infection. We treat the child and prepare to discharge her with an Rx for antibiotics and instructions for mom on the use of Tylenol and Motrin. At this point mom asks where the Tylenol and Motrin are. She says her "Gold Card" (Medical Assistance) will pay for the antibiotic but not the Tylenol/Motrin. She goes on to tell me she has no money and that if we don't supply the medicine then her daughter will not get it and will just end up back in the ER. Now let me describe this mom. She's wearing a top end ankle length leather coat, carrying a leather handbag from a designer I could never afford filled with at least 4 packs of cigarettes, covered in about a half dozen matching gold necklaces and bracelets not to mention the earrings and rings. Yet she receives assistance .

A young man comes in with 2ND degree burns on his hands and arms. He got these from an accident at Burger King where he works. His family hears about the injury and comes in to see him. Do they give him support? No, they start yelling and screaming at him that if he had just sat around at home collecting welfare like the rest of the family this would have never happened .

I was at the grocery store and kept hearing a baby cry. I ended up in line behind a couple with this crying child using food stamps to pay. The person at the cash register told them they were a little short. So what does the couple do? They put back the little bit of baby food that was there but keep the cocktail shrimp, crab legs and caviar .

If these types of abuses were stopped it would go a long way torward keeping ADAP funded.

If these types of abuses were stopped it would go a long way torward keeping ADAP funded.

LOL I bet we agree with each other more than we think. I just said a similar thing in a discussion last night to some family members.

Now that I quit living with the "heathen Yankees" after 23 (in OH) and moved back to the Bible Belt where they're suspicious that Obama is the AntiChrist (in SC) , I find plenty of people really believe in the same issues; but in this world of sound bites (anyone else remember blipverts from the MaxHeadroom movie http://en.wikipedia.org/wiki/Blipvert) and chat rooms and twitters, that our similarity of beliefs doesn't often come across. There are so many things that could be changed across the board to not spend more money, but to save more money, in the system, that it's nearly amazing, and really terrifingly sad and wasteful.

Up in "Yankee Land", even simply changes like computerizing the records so they don't have to scan my birth certificate in EVERY time I have an appointment for 13 years to having the same case worker intake me for medical card and food stamp approval at the same time (both programs need the exact same information) have been a great start at saving money that this country-bumpkin county I'm in now needs to be federally mandated to do also.

You are very correct. If only more was done across the board, I'm sure there is plenty of money available, at least here in the US, to not only fund ADAP, but things like IVF procedures and even good preventive medicine strategies that would save even more money in the long run.

I have seen many of those same people that you mentioned when I've gone for medical assistance. Heck my last roommate was one of those kind of scammers too, quite honestly, and I reported him dozens of times. But not me. My little ol' ID doc has taken care of all the minor issues (in his office where it's more cost effective) and I haven't used a hospital or ER for myself (knock on wood) in 11 yrs since I last had pnuemonia. (Though I did take my last late partner into the hospital. Non-Hodgkins lymphoma is not really a "treat at home" sort of disease. LOL)

don't either one of you get my started on "those" people in the grocery stores. While I'm using my handful of food stamps benefits to get enough tuna helper to last a month and their carts are loaded with steaks and roasts. Argh! Not to mention that I'll be walking my bags of groceries home (I haven't had a car in 3 yrs now, cause I'm just that poor) and they'll be driving off in that new gleaming SUV. It really should be a crime!

My aunt was an RN, then the head of a nursing school. Two dear friends are currently nursing, one as an LPN and the other as an RN. My mom-in-law (my late first partner's mom) is a retired RN. Why I even had a roomie for 7 yrs who went from being an LPN to an RN while I keep the roof over our heads so she could do the classes and study.

I thought she'd be great to have around if I ever was hospitalized for pneumonia again after my firt bout of PCP. Good idea, huh? To have my very OWN nurse. However (speaking of my last visit to the hospital), when I did go back in the hospital with just regular pnuemonia 2 years later, she was ALSO hopitalized, and for 4 days longer! with pnuemonia and sepsis!! What a mess we were for months recovering both of us "nursing" each other back to health.

Then there have been those Hospice nurses that have helped me twice as I lost not one but two long-term partners. Though both times, those nurses were only able to help out for a short 9 days, their insight, directions, and support was invaluable to me. Because of a promise I made to those nurses, I have scheduled an appt with a volunteer coordinator at my new HIV clinic to see about volunteering my time to help with Hospice.

Hmmmm.... indeed. I've also heard the hoop ear ring in the ER story.... First the bending over comments regarding people on ADAP , now the stereotypical stories as well. What's next the Neiman Marcus chocolate chip cookie story?

Here's a anti-stereotype story fer ya, I got this neighbor and she's a white woman. She uses her welfare check to pay for her beautiful white, gas guzzling, Ford Excursion. Her husband has a great job, but they divorced so she could get Medicaid for the chitlings. He lives at home however, he uses another address to help with the whole divorce lie. He in turn is taxed child support, but this goes back into the families bank account.

Presto!!! Free Medicaid for the wifey and kids..... Keep great white hope alive I say!!It what it is I guess.

Actually it never was. You took it that direction. What was being discussed was the fact that we are refusing treatment to those who need it to live, while extending it to those who want to start a life. It was a discussion for thought and not meant as some battle so we could lobby in Congress to stop which ever side lost.

I mean just so ya know.......

Like I've said all along I fully support what ever choice a woman makes. Whether it's IVF treatments, abortion, Lesbianism (word?), breast augmentation, breast reduction, tampons or pads, I don't care one bit.... Y'all people too! Just like me..... only difference is I pee on the seat and y'all pee through it.

And before the skeebo's a sexist comments start slingin, let me just say... they couldn't be furthest from the truth. I just hate when the underdog is always getting the carpet pulled out from underneath them. Whether it is a lady or in this case people getting their ADAP coverage swiped away.

Hmmmm.... indeed. I've also heard the hoop ear ring in the ER story.... First the bending over comments regarding people on ADAP , now the stereotypical stories as well. What's next the Neiman Marcus chocolate chip cookie story?

Here's a anti-stereotype story fer ya, I got this neighbor and she's a white woman. She uses her welfare check to pay for her beautiful white, gas guzzling, Ford Excursion. Her husband has a great job, but they divorced so she could get Medicaid for the chitlings. He lives at home however, he uses another address to help with the whole divorce lie. He in turn is taxed child support, but this goes back into the families bank account.

I'm a little stunned by your comments . First of all, as I've said previously, I never said or meant F*** people who receive ADAP. That was how you interpreted things. Secondly, you seem to be the one jumping to stereotype. These "stories" as you called them, are real life experiences I've had. The people in my "stories" are not all one race. One was white, one black, one hispanic and one interracial. I just didn't think that was important to tell. The important part was that they were playing the system and leaving less to go to those in real need. If your "story" is real, I'm disgusted by your neighbor too. That is just another example of a problem that should be dealt with so that we have more funds to help those in need.

Actually it never was. You took it that direction. What was being discussed was the fact that we are refusing treatment to those who need it to live, while extending it to those who want to start a life.

Maybe part of the problem here is miscommunication as well . I admit I am very, very sensitive about infertility and IVF. Once you get upset and get something stuck in your head it gets hard to really hear what others are saying . I've never heard of any assistance paying for IVF itself, have you? I've only heard about it sometimes paying for the children and families who result from it. I interpretted what has been said as IVF should be curtailed and or stopped because some of the families end up needing a lot of assistance afterwards. I felt and still do feel it is wrong to stop or curtail IVF procedures because some people will end up needing assistance.

Leatherman - Nice to find common ground with you .

After working in the ER I moved to working in the OR. Want to hear about another big waste of limited funds? PPTL (tying the tubes after pregnancy) is pretty common. The woman is already in the hospital and because of changes that happen after delivery, during that next 48 hours it's normally easier and faster to tie the tubes than at other times. I'm not sure about other states but here in PA, MA requires the woman to sign a form at least 30 days before the surgery. There is also a limit on how old the form can be. I don't remember that time for sure, but I think it is 60 days. I can't tell you how many times women wanted to have PPTL but whoops, the paperwork wasn't done during that timeframe. They end up not getting their tubes tied and eventually pregnant again.

I apologize for the assumption of race. When I usually hear stories of that nature they are usually racially influenced and not told in a positive light. Truth be told, if any race could get assistance while making an extra $8.50 an hour 40 hours a week they would do so. The system is especially detrimental to single mothers who have one child let alone more and $8.50 an hour just can't cut it. See those who receive financial assistance become engrossed in a cycle that is hard to break. If you work one hour you lose it.... you don't work at all you get $155 per household member, plus medicaid and housing. These options were not available to my mother before my step father came along and I can tell you my sister and I lived on potatoes literally. Probably the reason I am the way I am due to some kind of vitamin deficiency.

I am sorry though for one more thing. I did not realize you've had experience with IVF and if I had I would have backed off on some of my comments. I said them though and now all I can do is apologize.

I do want to clarify however, that it was never about the IVF treatments. It was its by product I guess for lack of a better term. The cost of the healthcare for the multiple births that was caused by it and before anyone starts with the Skeebo da Baby Killa routine, which simply is not the case... once these infants are born they deserve every medical treatment available to help them survive and at any cost.

I was once on ADAP myself and also getting minimal public assistance ($155FDST)... Just the constant hoops and crap I had to jump through almost made getting it and keeping it a job in itself, when at the time I had very little mental and physical energy. I remember nearly running out of meds and a member here helped me out. At the time I was by myself and in a new city, isolated and in my house....

But anyways that was then... Today's NFL Sunday and that's enough of that whiny crap. My wife let's me get the big TV from 11am to 12 midnight and it ain't nothing but football non stop, now that is one hell of a day off. Hmmmm I really do need to get out there and mow the yard. It's looking kinda janky...

If this was a hijack of sorts I'm sorry... I've got a couple teams in fantasy football playing to... Oh never mind I'll just wait til my wife wakes up and bother her with that.

OK so I am about to get myself into big trouble here but here goes: As a RN in an inner city ER I can honestly say that I agree with Skeebo that the abuse of public assistance programs is not limited or concentrated on any one race. Some of these folks take ambulances in for eye pain, stop in for knee pain that they have had for the last week because "they were in the area", or come in because they ran out of their medication and didn't bother to make an appointment with their primary physician to get a refill authorized. That is only a small sampling of the abuse I see day in and day out and I am telling you it gets old quick. My agreement ends here however. These same folks come in reeking of cigarette smoke, carry designer purses, wear designer jeans, and have the latest and greatest cell phone out there. Now I freely admit that I am pretty bitter about the smoking thing, I recently quit smoking due to the expense and damn it if I can't afford with a job I damn sure don't want to see anyone with health care that I am helping to pay for doing it either. Oh and before I get jumped on as being some sort of elitist snob, I had my first baby at 17, second baby at 19, and was a high school drop out, divorced on welfare so I have been on that side of the fence as well.

As for IVF possibly creating sick babies that may need assistance or medical bills families can't pay I say whats your point? Every pregnancy regardless of how it originated carries the same risk so if we are going to stop IVF we better stop all pregnancies.

Just adopt? It is not that easy. Over 35? Your too old. Ever have cancer? Even as a child? Sorry. Have any chronic illness? Sorry. Oh, and even if you jump through all of our hoops and get approved, that birth mother has 6 weeks to change her mind so you may have your heart broke anyway. Many over seas countries have also closed their borders so that is not an option either (someone I work with is trying this route).

As a "fatty" Leatherman I resent your admitted derogatory statements. You made your choices and I made mine. You advocate for ADAP which uses money from people with and without HIV to fund treatment for people with the illness (I have no problem with ADAP but am making a point here) yet don't agree with having to use some of your money to deal with overweight people because you are not bothered by that affliction? How does that work?

Bottom line I think we need to start advocating for personal responsibilty in this country and crack down on abuse of the medical and legal systems. If there was a limit on the malpractice lawsuits doctors wouldn't have to practice defensive medicine and every patient that hits the ER wouldn't get the $50,000 work up. Maybe if public assistance patients got a $25 copay for an ER visit that didn't result in a hospital admission (mine is $150) they would find an urgent care or wait for their clinic to open which is 1/4 of the cost. Maybe if a requirement for public assistance was that you are either suffereing from a chronic condition that renders you too ill to work or you have to go to school / show progress towards self sufficiency (just as the cash benefit does), there wouldn't be a fund shortage. There is plenty of money if we can just stop the bleeding and get it where it truly needs to be.

When I go to the local breakfast joint they always have them flavored tooth picks by the register. My wife and I take a quick look around, cover the kids eyes, and swipe two without paying for them. It's funny because then everyone behind us does it too, except their real bold and look the cashier in the eye and then they swipe the wood...

You're always going to have a group that abuses anything that is given to them. Whether it's going over by one minute on your 10 minute break at work or working the system, it's just the way it is and it shouldn't cause those who do need it to be frowned upon by those who think they are abusing the system.

I was married to a woman when I was 19 who abused the system much in the way you described here. Trust me that one pair of designer jeans gets worn everyday and the gold is fake.... just like the blue eye contact lenses were... She's never worked a day in her life and she is approaching 50 now, and Habitat for Humanity has given her a home on an acre of land. She has a new SUV hybrid and I drive an old Neon... and with the exception of two years when I was sick have always busted my ass working...

Yet if I get sick and can't work any longer disability won't accept me til I am damn near dead... yet my ex-wife is on it and nothing is wrong with her.

My best friend is currently a single parent with three kids. Due to the fact that she is going to school right now she receives medical assistance and day care assistance. She takes her kids to the clinic, goes to the clinic herself, and has only gone to an urgent care center once when one of the kids needed stitches on a Saturday. When I was going to school I too was on State Aid and used it in the same way. There was no urgent care so I brought my kids to the ER for stitches and broken bones that occured on off hours, otherwise we went to the clinic. This, in my opinion, is how it should be. I have no issues with people who require state assistance for whatever reason as long as they use it like those of us who have to pay out of pocket do.

With dwindling resources, increased demand, and increased cost there is no room for waste any longer and it should not be tolerated. It boggles my mind that folks are being put on a waiting list for HIV meds right now when I see thousands upon thousands of dollars being wasted every day that I work. I don't understand how people can be denied life saving medication but the guy that has H1N1 can present to two different ER's the same day and he has the right to be seen in both. This despite the fact that it is all over the news that unless you are in a high risk group or getting worse you should stay home if you have H1N1.

At my hospital, they did an audit and found out that several people were leaving work and calling while they were already on their way home to punch out. This of course pissed off the the hospital as these people were stealing so they re wrote the policy and it now states that you have to remain on the floor until exactly 30 minutes after your shift and can not call in to punch out nor can you write your time out on a time slip. Now I didn't even know you could call back to punch out (I have to admit that the people who thought of it were pretty clever) but I got caught in the same net and am required to follow the same rules. The same type of thing needs to happen with the state assistance programs. There will be some innocent people caught in the net there as well but it is the only way to stop the abuse.

I have never even heard of this-- talk about asking to get fired! We have video cameras at the time clock.

That is actually how the whole thing started. One employee was a problem and they were looking for a reason to fire her so she was turned in for doing this. She then filed a complaint and said if she was going to be fired for it there were more people that needed to be fired as well. That kicked off the house wide audit. What they did was pull all of the parking ramp data and compare what time you punched out to what time you left the ramp. These fools were leaving the ramp at the top of the hour and calling to punch out 30 minutes later.